La Yun Bo, Kim Sun Mi, Jang Mijung, Ahn Hye Shin, Lyou Chae Yeon, Kim Mi Sun, Kim Sun Ah, Song Tai-Kyong, Yoo Yangmo, Chang Jin Ho, Kim Youngmi
Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea (B.L.Y., S.M.K., M.J.); Department of Radiology, Chung-Ang University Hospital, Seoul, Korea (H.S.A.); Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Korea (C.Y.L.); CHA Gangnam Health Promotion Center, Seoul, Korea (M.S.K.); Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Korea (S.A.K.); Department of Electronic Engineering and Sogang Institute of Advanced Technology, Sogang University, Seoul, Korea (T.-K.S., Y.Y., J.H.C.); and Department of Radiology, Sungkyunkwan University Samsung Changwon Hospital, Changwon, Korea (Y.K.).
J Ultrasound Med. 2015 May;34(5):749-57. doi: 10.7863/ultra.34.5.749.
The purpose of this study was to investigate the added value of diffuse optical tomographic categories combined with conventional sonography for differentiating between benign and malignant breast lesions.
In this retrospective database review, we included 145 breast lesions (116 benign and 29 malignant) from 145 women (mean age, 46 years; range, 16-86 years). Five radiologists independently reviewed sonograms with and without a diffuse optical tomographic category. Each lesion was scored on a scale of 0% to 100% for suspicion of malignancy and rated according to the American College of Radiology Breast Imaging Reporting and Data System classification. Diagnostic performance was analyzed by comparing area under receiver operating characteristic curve values. Reader agreement was assessed by intraclass correlation coefficients.
In the multireader multicase receiver operating characteristic analysis, adding a diffuse optical tomographic category to sonography improved the diagnostic accuracy of sonography (mean areas under the curve, 0.923 for sonography alone and 0.969 for sonography with diffuse optical tomography; P = .039). The interobserver correlation was also improved (0.798 for sonography alone and 0.904 for sonography with diffuse optical tomography). The specificity increased for 4 reviewers from a mean of 19.5% to 45.8% (P < .001 for reviewers 1-4; P = .238 for reviewer 5) with no significant change in the sensitivity. When the diffuse optical tomographic category was applied strictly, the specificity increased for all reviewers from a mean of 19.5% to 68.3% (P < .001 for all reviewers) with no significant change in the sensitivity.
The addition of diffuse optical tomographic categories to sonography may improve diagnostic performance and markedly decrease false-positive biopsy recommendations.
本研究旨在探讨漫射光学断层成像类别与传统超声检查相结合在鉴别乳腺良恶性病变方面的附加价值。
在这项回顾性数据库研究中，我们纳入了145名女性的145个乳腺病变（116个良性病变和29个恶性病变）（平均年龄46岁；范围16 - 86岁）。五名放射科医生独立审查有无漫射光学断层成像类别的超声图像。每个病变根据恶性可疑程度在0%至100%的范围内评分，并根据美国放射学会乳腺影像报告和数据系统分类进行评级。通过比较受试者操作特征曲线下面积值来分析诊断性能。通过组内相关系数评估阅片者之间的一致性。
在多阅片者多病例受试者操作特征分析中，超声检查添加漫射光学断层成像类别可提高超声检查的诊断准确性（曲线下平均面积，单纯超声检查为0.923，超声检查联合漫射光学断层成像为0.969；P = 0.039）。观察者间的相关性也得到了改善（单纯超声检查为0.798，超声检查联合漫射光学断层成像为0.904）。4名阅片者的特异性从平均19.5%提高到45.8%（阅片者1 - 4，P < 0.001；阅片者5，P = 0.238），而敏感性无显著变化。当严格应用漫射光学断层成像类别时，所有阅片者的特异性从平均19.5%提高到68.3%（所有阅片者，P < 0.001），敏感性无显著变化。
超声检查中添加漫射光学断层成像类别可能会提高诊断性能，并显著减少假阳性活检建议。
